Concurrent vesicoperitoneal and vesicovaginal fistulae

Although rare in the USA, vesicovaginal fistulae are usually associated with postoperative complications. Even more rarely seen, vesicoperitoneal fistulae can also present postoperatively. Both types of fistulae pose as diagnostically challenging and can be difficult to manage. We describe a case report of a patient with both vesicovaginal and vesicoperitoneal fistulae after a laparoscopic-assisted vaginal hysterectomy who presented with abdominal pain and anuria. Cystogram and outpatient cystoscopy were imperative in the diagnosis. She was conservatively managed with continuous bladder drainage via indwelling catheter resulting in an ideal recovery without requiring reoperation.     

Ileoscopy via Stoma After Diverting Ileostomy: A Safe and Effective Tool to Evaluate for Crohn’s Recurrence of Neoterminal Ileum

Background  

Recurrence of Crohn’s disease (CD) most commonly occurs in the neoterminal ileum near the stoma after fecal diverting ileostomy. Methods used to assess CD recurrence include small bowel series, ileostomy injection, computed tomography (CT) enterography, and capsule endoscopy. Retrograde ileoscopy via stoma is also a valuable tool for recognition of CD recurrence; however, this technique has not been formally studied.